0940 The Association of Obstructive Sleep Apnea with Markers of Accelerated Aging: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Abstract Introduction There is differing susceptibility to age-related health complications. A variety of circulating biomarkers of biological aging have been developed. Obstructive sleep apnea (OSA) is a prevalent sleep disorder that may contribute to premature aging, possibly through pathways involving intermittent hypoxia, sleep fragmentation, oxidative stress, and inflammation. The aim of this study was to systematically review and summarize the literature with respect to the relationship between OSA and circulating markers of premature aging. Methods Following the 2020 PRISMA guidelines, five electronic databases (MEDLINE, Embase, CINAHL, Cochrane, PsycINFO) were searched from inception to October 2024. Eligibility criteria included full manuscript English studies on adult humans with OSA (apnea-hypopnea index ≥ 5) that evaluated a circulating marker of aging. Quality assessments were conducted using standard methods. A random-effects meta-analysis was conducted on each marker. Studies investigating multiple markers at the same time were corrected using robust variation estimation (RVE). Results Twenty-five studies (8396 participants) were included in our review. Four studies investigated two markers simultaneously. Biomarkers included telomere length (TL, n=17), mitochondrial DNA (mtDNA, n=4), epigenetic age acceleration (EAA, n=2), sirtuins (SIRT, n=4), cyclin-dependent kinase inhibitor 2A (P16) (n=1), and autophagy protein 5 (ATG5) (n=1). Meta analyses were conducted on 15 studies that had a mean with standard deviation. There was significant association between OSA and shorter TL (unadjusted mean (95%CI) = -0.405 (-0.606, -0.203), p=0.0019). SIRT levels were lower in OSA participants; however, the meta-analysis was only borderline significant after RVE (mean (95%CI) = - 1.93 (-4.74, 0.879), p=0.09). MtDNA (mean (95%CI) = 0.669 (-1.29, 2.63), p=0.144) studies yielded mixed results. OSA was linked to increased EAA. The sole P16 and ATG5 studies demonstrated greater premature aging in OSA. Conclusion This systematic review highlighted a variety of markers of premature aging that may be impacted by OSA. Some markers were referenced in much higher frequency than others (TL), and thus had stronger evidence. OSA is greatly underdiagnosed, but the presence of OSA likely has an important role in premature aging. Further research is needed to understand the effects of OSA on biological aging, and assess whether these are associated with more robust age-related clinical outcomes. Support (if any)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.031 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.030 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".